摘要
目的探讨关节镜下修复术和肱二头肌长头腱切断固定术治疗Ⅱ型上盂唇前后损伤（superior labrum from anterior to posterior，SLAP）的疗效。方法计算机检索PubMed、中国期刊全文数据库、维普数据库、万方数据库，查阅关节镜下SLAP修复术和肱二头肌长头腱切断固定术治疗Ⅱ型SLAP损伤的随机对照试验和病例对照研究。同时手工检索国内主要骨科杂志，并查阅所纳入文献的参考文献作为补充资料。由两人按照制定的纳入及排除标准独立对文献进行筛选、资料提取、质量评价。采用Cochrane协作网提供的RevMan5-3软件进行Meta分析，比较两种手术术后加州大学洛杉矶分校（University of California at Los Angeles，UCLA）肩关节评分系统、美国肩肘外科协会（American Shoulder and Elbow Surgeons，ASES）评分、疼痛视觉模拟评分（visual analogue scale，VAS）、简明肩关节功能测试（simpleshoulder test，SST），评价手术疗效。结果7篇符合标准的文献纳入研究，其中随机对照试验2篇、病例对照研究5篇。患者共256例，其中行SLAP修复术125例（SLAP修复组）、肱二头肌长头腱切断固定术131例（肌腱切断固定组）。Meta分析结果显示：肌腱切断固定组UCLA评分总分[MD=2．55，95％CI（0．57，4．53），P=0．01]和UCLA评分系统中的肩关节功能[MD=0．62，95％CI（0．21，1．02），P=0．003]与SLAP修复组比较差异有统计学意义；UCLA评分系统中的疼痛[彻=0．99，95％CI（-0．15，2．14），P=0．09]、前屈范围[MD=0．16，95％CI（0．01，0．32），P=O．06]、前屈肌力[MD=O．03，95％CI（-0．15，0．22），P=0．74]、满意度[SMD=0．18，95％C1（-0．57，0．93），P=0．64]与SLAP修复组比较差异均无统计学意义。肌腱切断固定组ASES评分[MD=6．32，95％CI（2．55，10．08），P=0．001]与SLAP修复组比较差异有统计学意义。两组VAs[MD=0．54，95％CI（-0．64，
Objective To evaluate the effects of SLAP repair and biceps tendon tenotomy and fixation in treating type Ⅱ superior labrum from anterior to posterior in shoulder arthroscopy. Methods PubMed, CNKI, VIP, and Wanfang database were searched electronically to screen randomized controlled trials and non randomized controlled trials that comparing two surgical methods for type Ⅱ SLAP lesions. In addition, we also retrieved the domestic orthopedic magazine and searches references that we had included in the present study. According to the criterion, screening literatures, data extraction and quality assessment were conducted by two reviewers independently. Meta-analysis was performed by using RevMan 5.3 software to evaluate UCLA scores, ASES scores, VAS scores and SST scores. Results A total of 7 articles were included in the present study, including 3 literatures in Chinese and 4 in English. There were 2 randomized controlled trials and 5 non randomized controlled trials. Two hundred and fifty-six patients were enrolled in the present study, including one hundred and twenty-five patients with SLAP repair and one hun- dred and thirty-one patients with biceps tendon tenotomy and fixation. Meta-analysis showed that there was significant difference in total score of UCLA [MD=2.55, 95%CI（0.57, 4.53）, P=0.01] and shoulder function in the UCLA scoring system [MD=0.62,95% CI（0.21,1.02）, P=0.003] compared with SLAP repair. There was no difference in the UCLA scoring system, including pain [MD= 0.99, 95%CI（-0.15, 2.14）, P=0.09], flexion [MD=0.16, 95%C1（0.01, 0.32）, P=0.06], strength [MD=0.03, 95%CI（-0.15, 0.22）, P= 0.74], satisfaction [SMD=O.18, 95% CI（-0.57, 0.93）, P=0.64] compared with SLAP repair. There was significant difference in ASES scores [MD= 6.32,95%CI（2.55, 10.08）, P=0.001] between two groups. There was no difference in VAS scores [MD=0.54, 95%CI （-0.64,1.72）, P=0.37] and SST scores [MD=0.81, 95%CI（-0.23, 1.86）, P=0.13] between two groups. Conclusion The UCLA scores, ASES score
作者
潘昭勋
李杰
孙超
杜德凯
闵小军
Pan Zhaoxun;Li fie;Sun Chao;Du Dekai;Min Xiaojun(Department of Orthopaedics,the Eighty-ninth Hospital of PLA,Weifang 261021,China)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2018年第17期1063-1071,共9页
Chinese Journal of Orthopaedics
基金
全军后勤科研计划项目（CJN13J002）
